Provider Demographics
| NPI: | 1225710668 |
|---|---|
| Name: | WS WELLNESS LLC |
| Entity type: | Organization |
| Organization Name: | WS WELLNESS LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | OWNER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | EMILIE |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | BREEDING |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | NP |
| Authorized Official - Phone: | 937-759-0545 |
| Mailing Address - Street 1: | 9049 SPRINGBORO PIKE |
| Mailing Address - Street 2: | |
| Mailing Address - City: | MIAMISBURG |
| Mailing Address - State: | OH |
| Mailing Address - Zip Code: | 45342-4926 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 937-759-0545 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 9049 SPRINGBORO PIKE |
| Practice Address - Street 2: | |
| Practice Address - City: | MIAMISBURG |
| Practice Address - State: | OH |
| Practice Address - Zip Code: | 45342-4926 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 937-759-0545 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2023-08-04 |
| Last Update Date: | 2023-08-21 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 2084P0805X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Geriatric Psychiatry | Group - Multi-Specialty |
| No | 207RB0002X | Allopathic & Osteopathic Physicians | Internal Medicine | Obesity Medicine | Group - Multi-Specialty |
| Yes | 207QB0002X | Allopathic & Osteopathic Physicians | Family Medicine | Obesity Medicine | Group - Multi-Specialty |
| No | 104100000X | Behavioral Health & Social Service Providers | Social Worker | Group - Multi-Specialty | |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 261QM2500X | Ambulatory Health Care Facilities | Clinic/Center | Medical Specialty | |
| No | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psychiatric/Mental Health | Group - Multi-Specialty |
| No | 207T00000X | Allopathic & Osteopathic Physicians | Neurological Surgery | Group - Multi-Specialty | |
| No | 207VF0040X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Urogynecology and Reconstructive Pelvic Surgery | Group - Multi-Specialty |
| No | 2084A2900X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurocritical Care | Group - Multi-Specialty |
| No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
| No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health | |
| No | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty |